Provider Demographics
NPI:1841811627
Name:TRUE SOUTH HOME HEALTH PRACTITIONERS CORP
Entity type:Organization
Organization Name:TRUE SOUTH HOME HEALTH PRACTITIONERS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GILBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-459-5990
Mailing Address - Street 1:PO BOX 652322
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33265-2322
Mailing Address - Country:US
Mailing Address - Phone:954-459-5990
Mailing Address - Fax:
Practice Address - Street 1:11300 SW 45TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5542
Practice Address - Country:US
Practice Address - Phone:954-459-5990
Practice Address - Fax:305-470-7451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-02
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health